Abdominal wall vaccination metastasis following percutaneous endoscopic gastrostomy

Background: Percutaneous endoscopic gastrostomy (PEG) meanwhile has become an accepted and routinely used alternative to surgical gastrostomy or nasog astric feeding tubes in patients requiring long-term nutritional support. M ajor complications are rare. In this paper, we report on a patient with a v accination metastasis following PEG insertion. Case Report: The patient had advanced squamous cell carcinoma of the esophagus. A fast-growing metastas is was found at the site of PEG insertion - without distant metastasis or l ocal tumor progress. It can be supposed that there was a mechanical transpo rt of tumor cells to the cut by the PEG catheter during PEG insertion. This abdominal wall metastasis was treated with radiotherapy alone, without sur gery. The patient is still alive 9 months after the first sign of wall meta stasis. Conclusion: We demonstrated that radiotherapy alone is an effective , safe, and well tolerated treatment. Abdominal wall metastases do not nece ssarily require surgery.